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Tickborne Diseases of the United States


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*Rickettsia parkeri* Rickettsiosis					minus icon
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			HomeTick IDOverview of Tickborne DiseasesLyme DiseaseTickborne Relapsing Fever (TBRF)Hard Tick Relapsing FeverAnaplasmosisEhrlichiosisRocky Mountain Spotted FeverRickettsia parkeri RickettsiosisTularemiaBabesiosisHeartland and Bourbon Virus DiseasesColorado Tick FeverPowassan Virus DiseaseTickborne Diseases AbroadTick Bites/PreventionLyme Disease Prophylaxis After Tick Bite					Related Pages
										Agent*Rickettsia parkeri**R. parkeri* is closely related to *R. rickettsii*, the causative agent of Rocky Mountain spotted fever (RMSF). *R. parkeri* rickettsiosis and RMSF have similar signs and symptoms, including fever, headache, and rash, but also typically include the appearance of an inoculation eschar (seen at right) at the site of tick attachment. Eschar is not common in cases of RMSF.Scabbed region at the site of a tick bite called an escharWhere Found*R. parkeri*rickettsiosis is transmitted by Gulf Coast ticks found primarily in the southeastern United States, with focal populations in the northeastern, midwestern, and southwestern United States.Incubation Period2–10 daysSigns and Symptoms*R. parkeri* rickettsiosis is characteristically less severe than RMSF and almost always associated with an inoculation eschar (ulcerated, necrotic lesion) at the site of tick attachment. Several days after an eschar appears, the following can develop:
Fever
Headache
Rash (sparse maculopapular or papulovesicular eruptions on the trunk and extremities)
Muscle aches**NOTE:***R. parkeri* rickettsiosis can be difficult to distinguish from RMSF and other spotted fevers, especially during early stages of these diseases. Eschars are uncommonly identified in persons with RMSF.General Laboratory FindingsMildly elevated hepatic transaminases
Mild leukopenia
Mild thrombocytopenia, less commonWarning symbolCONFIRMATION OF THE DIAGNOSIS IS BASED ON LABORATORY TESTING, BUT ANTIBIOTIC THERAPY SHOULD NOT BE DELAYED IN A PATIENT WITH A SUGGESTIVE CLINICAL PRESENTATION.Laboratory DiagnosisDetection of rickettsial DNA by PCR in eschar swab, whole blood, or skin biopsy.
Demonstration of a four-fold rise in IgG-specific antibody titer by indirect immunofluorescence antibody (IFA) assay in paired serum samples. The first sample should be taken within the first 2 weeks of illness and the second should be taken 2 to 4 weeks later.**NOTE:** Species-level testing for *R. parkeri* is not commercially available. RMSF antibody tests are available commercially and often cross-react.
**NOTE:** IgM antibodies are less specific than IgG antibodies and are more likely to generate false positives. IgM results alone should not be used for laboratory diagnosis.
**NOTE:** Acute antibody results cannot independently be relied upon for confirmation.TreatmentSee Rocky Mountain spotted fever treatment.ReferencesCenters for Disease Control and Prevention. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsioses, ehrlichioses, and anaplasmosis—United States: a practical guide for health care and public health professionals. *MMWR* 2016;65 (No.RR-2).
Paddock CD, Finley RW, Wright CS, et al. *Rickettsia parkeri* rickettsiosis and its clinical distinction from Rocky Mountain spotted fever. *Clin Infect Dis* 2008;47:1188-96.
Paddock CD, Goddard J. The evolving medical and veterinary importance of the Gulf Coast tick (Acari: Ixodidae). *J Med Entomol* 2015;52:230–52.
Straily A, Feldpausch A, Ulbrich C, et al. Notes from the Field: *Rickettsia parkeri* rickettsiosis—Georgia, 2012–2014. *MMWR Morb Mortal Wkly Rep* 2016;65:718-719.
Herrick KL, Pena SA, Yaglom HD, et al. *Rickettsia parkeri* rickettsiosis, Arizona, USA. *Emerg Infect Dis* 2016;22:780-785.Top of Page
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						Page last reviewed:  August 5, 2022					Content source: 	Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD) homeTickborne Diseases of the United StatesTick IDOverview of Tickborne DiseasesLyme DiseaseTickborne Relapsing Fever (TBRF)Hard Tick Relapsing FeverAnaplasmosisEhrlichiosisRocky Mountain Spotted Fever*Rickettsia parkeri*RickettsiosisTularemiaBabesiosisHeartland and Bourbon Virus DiseasesColorado Tick FeverPowassan Virus DiseaseTickborne Diseases AbroadTick Bites/PreventionLyme Disease Prophylaxis After Tick Bite


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